Previously, investors mainly considered Golden Visa programs as a tool for global mobility. Still, it remains part of their decision, but today with a slight difference: they look for Golden Visa countries with the best healthcare systems as a major decision factor. Especially with the rising healthcare costs in the US, many Americans are now looking for an affordable public healthcare system abroad, particularly in Europe, through Golden Visa countries.
Recent data also contributes to the seriousness of rising healthcare costs in the US. According to the West Health-Gallup Center on Healthcare in America, 48% of debt holders consider healthcare costs as a major factor, and nearly one in four US workers say they remain in jobs they do not want because they rely on employer-sponsored health insurance. Accordingly, Americans now look for affordable healthcare overseas, and the need to find affordable healthcare is reflected in the search for Golden Visa countries with the best healthcare systems.
Key Highlights of Golden Visa Countries with The Best Healthcare Systems
- • Portugal leads the list with the highest Healthcare Index score among the Golden Visa countries reviewed, at 51.99.
- • Italy stands out for medical infrastructure, with a score of 98.3, making it particularly notable for the strength of its healthcare facilities and professionals.
- • Greece combines a relatively strong healthcare system with one of the lowest Golden Visa entry points, with qualifying real estate investments starting from €250,000.
- • Golden Visa residency does not automatically guarantee free public healthcare. Access to public healthcare may depend on residency status, social security contributions, or additional registration.
- • Private healthcare remains important for expats, even in countries with established public systems, particularly for shorter waiting times and easier specialist access.
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Why Americans Look for Golden Visa Countries with The Best Healthcare System?
Healthcare is becoming a bigger concern for Americans. In 2025, the average annual premium for employer-sponsored family health insurance in the US reached $26,993. It rose by 6% in one year. Workers paid an average of $6,850 themselves.
This is putting countries with lower healthcare costs on the radar. Some Golden Visa destinations offer high quality public and private healthcare at much lower cost than in the US.
For many Americans, moving abroad is not an immediate decision. It can simply mean having a Plan B if healthcare costs continue to rise. According to Get Golden Visa’s The Great American Retirement Exodus Report, healthcare concerns as one factor behind some older Americans considering a move abroad.
In this article, to identify the Golden Visa countries with the best healthcare, we looked beyond treatment costs. We considered Golden Visa programs, English-speaking medical staff, hospital standards, health insurance costs, access to private healthcare, and the overall affordability of medical care.
Golden Visa Countries with The Best Healthcare Systems in 2026
1. Portugal
- Healthcare Index: 51.99 (Moderate)
- Medical Infrastructure and Professionals: 68.21
- Medicine Availability and Cost: 60.36
Considering EU countries with the best healthcare systems, Portugal’s healthcare system stands out with Serviço Nacional de Saúde (SNS). It provides free medical coverage to some extent and at reasonable costs.
To benefit from Portugal’s system, you need to receive your residency status. So, through which visas can you do that? Initially, you can invest in Portugal Golden Visa investment funds starting at €500,000. Through this Portugal Investment Visa, you can obtain 5 years of residency, and if you meet the minimum stay requirements, you can get citizenship within 10 years*. Apart from this, you can go for D7 if you have a passive income (mostly preferred by retirees) and D8 if you work as a digital nomad or freelancer.
After your registration with the Serviço Nacional de Saúde (SNS), your doctor will be appointed to you directly. Mainly, it will be one of the first contacts that you will get in touch with in case you need a basic treatment. In urban areas, you can mostly encounter English-speaking professionals and well-equipped medical services. However, the likelihood will get lower as you move to rural areas.
At this point, you can prefer private healthcare providers to get quick processing times. For this, you may also consider having private insurance, costing €30 to €150 per month.
2. Italy
According to the Global Health Security Index, Italy scored 51.9 with its Servizio Sanitario Nazionale (SSN). Additionally, the World Health Organization (WHO) puts it among the top countries with the best healthcare infrastructure. It offers both public and private healthcare systems to its residents.
To register for the healthcare system in Italy through Azienda Sanitaria Locale (ASL), you need a residence visa. If you plan to move here via the Italian Golden Visa, you have to make a qualifying investment of at least €250,000. This residency by investment program initially provides you 2-year residence, which is renewable three times.
On the other hand, you can also consider applying for Italy’s Digital Nomad Visa, which is valid for one year. For this program, you need to show an annual income of at least €28,000. Both of these programs allow you to include your family members and travel freely in the Schengen area.
Once you are registered with the system, your basic treatment costs will be covered. You can go to your family doctor free of charge anytime. Note that you are asked to copay €36 for specialized visits or some procedures. Your children up to 16 can benefit from free dental treatment. However, complicated treatments such as laser eye surgery or cosmetic surgeries are not covered by the government.
Private healthcare is also available and is mostly preferred for shorter waiting periods.
3. Greece
- Healthcare Index: 46.24 (Moderate)
- Medical Infrastructure and Professionals: 70.06
- Medicine Availability and Cost: 58.53
Based on the GHSI index, Greece healthcare system ranks 51.5, which shows a modest improvement of 0.9 points compared to 2019. The country has both private and public healthcare options for its residents. The public system is called the National Health System (ESY), offering free or subsidized treatment to all of its residents.
If you want to benefit from ESY, you have to get your residency status. One of the outstanding options includes Greece Golden Visa. Under the regime of this program, you can qualify for Greece residency through a real estate purchase of at least €250,000. If you complete the process successfully, you will get a five-year residence permit, which is renewable as long as you keep the property.
Once you complete your registration, you can benefit from the Greek healthcare system. Visits to your family doctor or general practitioner are typically free of charge. However, dental care is limited under the public system, with only basic treatments covered. More complex procedures like orthodontics or cosmetic treatments must be paid out-of-pocket.
Private healthcare is available and often chosen for faster access, shorter waiting times, and a broader range of services, especially in major cities.
4. Malta
- Healthcare Index: 38.43
- Medical Infrastructure and Professionals: 66.73
- Medicine Availability and Cost: 53.04
Known for its Mediterranean climate, Malta has both public and affordable private healthcare systems with English-speaking professionals. If you are an EU citizen, you can benefit from the public healthcare system via EHIC. For non-EU citizens, the requirement for the Malta healthcare system differs. You must first be a legal resident.
In terms of legal residency options, the Malta Golden Visa, also known as the Permanent Residency program, is mostly preferred by investors who wish to make real estate investments. There is officially two investment options;
- One is to lease a property in Malta or Gozo, which costs around €14,000 per year (totaling a minimum investment of €169,000 for 5 years with the additional fees)
- Two is to buy a property in Malta or Gozo, which must be at least €375,000 (totaling a minimum investment of €474,000 with additional fees)
Second condition to benefit from public Maltese healthcare is that you must contribute to the Malta social-security system through Maltese employment, etc. Otherwise, you can opt for private health insurance, which can cost around €150-€400 per year.
For UK citizens, there is a special arrangement between the two countries. Under the Reciprocal Health Agreement (RHA), they can register with Malta’s Entitlement Unit and receive an RHA Entitlement Certificate; then they can benefit from public healthcare.
5. Panama
- Healthcare Index: 36.74
- Medical Infrastructure and Professionals: 74.26
- Medicine Availability and Cost: 56.10
Compared to many European countries, Panama has a different healthcare structure. There are basically three routes to benefit:
- MINSA: It is a public healthcare system for the general population
- CSS: Social Security Healthcare for insured workers and their dependents
- Private healthcare
So, there are two public healthcare systems. The first is MINSA, referring to the Ministerio de Salud (Ministry of Health). It provides public healthcare services to the general population, including people who are not covered by Panama’s social security system. Additionally, you do not need to be a legal resident or enrolled to access MINSA. However, you might pay extra fees, which are comparatively low.
In terms of CSS (Caja de Seguro Social), you must move to Panama and actually work there. For private healthcare, you can benefit upon arrival without any additional requirements, which is again less expensive compared to the US healthcare system.
What attracts investors here is its Panama Qualified Investor Visa program. Thanks to its territorial tax system and strategic geographic location, Panama provides investment options starting from a minimum of USD 300,000 in Panamanian real estate.
6. Latvia
- Healthcare Index: 42.92
- Medical Infrastructure and Professionals: 71.54
- Medicine Availability and Cost: 57.69
Similar to many European countries, Latvia has both public and private healthcare systems. However, not every expat is eligible for Latvia’s state-funded healthcare system. The system requires you to have permanent residency to benefit from it. In other words, you cannot qualify for it if you have a temporary residency.
As an example, even if you have invested in Latvia Golden Visa, which is valid for 5 years and renewable as long as you keep your investment, you still need to get private health insurance with coverage around €30,000 and can only benefit from the private healthcare system.
Fortunately, the cost of private healthcare is quite manageable, particularly compared with the US. With the right private health insurance coverage, you might have access to fast treatment at comparatively low prices.
7. Hungary
- Healthcare Index: 41.97
- Medical Infrastructure and Professionals: 74.88
- Medicine Availability and Cost: 58.95
Hungary is mostly preferred for its affordability through both its public and private healthcare sectors, compared to other EU countries. The public healthcare system is mainly funded through social security contributions and is administered by the National Health Insurance Fund (NEAK). EU citizens can benefit from it through a valid EHIC. However, non-EU citizens do not automatically get access to Hungary’s public healthcare. They need both legal residency and coverage under the Hungarian social security system.
One of the ways to establish residency is the Hungarian Golden Visa program. It provides a 10-year residency card upon investing a minimum of €250,000 in real estate investment funds. It is renewable for another 10 years if you maintain your investment.
Once you get your residency and are supported by the Hungarian social security system through employment, you can get registered within the Hungarian health insurance system and receive a TAJ number.
Private healthcare is also widely available, particularly in Budapest, and is generally considered relatively affordable compared with many Western European countries.
8. Spain
- Healthcare Index: 48.13
- Medical Infrastructure and Professionals: 96.87
- Medicine Availability and Cost: 86.79
Around 62% of people state that they are satisfied with the quality of healthcare in Spain, according to the OECD. In line with this data, the country offers both a public and private healthcare system. The public system, known as the Spanish National Health System (SNS), is mainly funded through taxation.
While all EU citizens can access public healthcare through EHIC, non-EU citizens get access depending on their residency and social security status. In terms of legal residency options, Spain’s Non-Lucrative Visa is a popular option for non-EU citizens who have sufficient financial resources to live in Spain without working.
However, holding a Spanish residency does not automatically provide access to Spain’s public healthcare system. Since they are generally not working in Spain and therefore may not be contributing to the Spanish social security system. Therefore, they typically rely on the private health insurance obtained as part of their residence application.
Private healthcare is widely available throughout Spain and is commonly used by expats. It generally offers shorter waiting times and easier access to specialists compared with the public system.
9. Malaysia
- Healthcare Index: 32.52
- Medical Infrastructure and Professionals: 73.36
- Medicine Availability and Cost: 53.59
Malaysia has a two-tier healthcare system consisting of public and private healthcare. The public system is funded mainly through taxation and is heavily subsidized by the government. At the same time, Malaysia also has an extensive private healthcare sector that is particularly popular among expats and medical tourists.
Foreigners can use Malaysia’s public hospitals and clinics, but they generally do not benefit from the heavily subsidized rates available to Malaysian citizens. Instead, non-citizens are charged separate foreign-patient fees. As a result, many expats prefer private healthcare, where English is widely spoken and waiting times are generally shorter.
In terms of legal residency options, the Malaysia My Second Home (MM2H) program is a long-term residence option particularly popular among retirees and financially independent foreigners.
However, obtaining residence through MM2H does not provide the same direct public healthcare benefits available to Malaysian citizens. MM2H residents can still receive treatment at government hospitals, but they are generally charged at the rates applicable to foreigners.
For this reason, private healthcare and health insurance are particularly relevant for MM2H residents. Malaysia has a large network of private hospitals and specialist clinics, particularly in cities such as Kuala Lumpur and Penang. Expats can use these facilities by paying directly or through private health insurance.
10. Thailand
- Healthcare Index: 33.01
- Medical Infrastructure and Professionals: 67.36
- Medicine Availability and Cost: 50.73
If you are moving to Thailand as an expat, the good news is that healthcare is one of the country’s strong points. Thailand has a large public healthcare network alongside a well-developed private sector, particularly in Bangkok and other major cities. It is also a major medical tourism destination, so private hospitals are accustomed to treating international patients.
To benefit from public healthcare, you must first get residency in Thailand. One way to do that is through its Golden Visa, also known as the Thailand Privilege Residence and Long-Term Residence Program. It is a residency program offering long-term residency up to 20 years.
The second requirement is to contribute to Thailand’s Social Security Scheme. For instance, if you work legally for a Thai employer, you may be covered through that system. You generally register with a hospital or hospital network and receive treatment through the contracted provider rather than simply choosing any hospital whenever you need care.
If you are living in Thailand without being covered through employment, you should not assume that the public universal system will cover you. In practice, many expats rely on private health insurance and private hospitals.
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FAQ on the Golden Visa Countries with the Best Health Care Systems
What is the Global Health Security Index (GHS Index)?
The Global Health Security Index is a comprehensive assessment that evaluates countries’ capacities to prevent, detect, and respond to infectious disease threats.
How many countries have free healthcare?
Although it depends on how “free” healthcare is defined, we can say there are roughly 70-80 countries worldwide that provide universal or near‑free healthcare.
Is healthcare free in European Countries?
Healthcare in Europe is not entirely free, but most European countries offer universal healthcare. This means that their residents have access to essential medical services, often at low or no direct cost.
Where are the best doctors in the world?
The best doctors in the world are often found in countries with top-ranked healthcare systems and medical education. These include the United States, Germany, Switzerland, Japan, and the United Kingdom.
Which countries have the worst healthcare?
Countries with the poorest healthcare include the Central African Republic, South Sudan, Chad, Lesotho, Somalia, Sierra Leone, and Nigeria.
